There seems to be a small baby boom taking place in my dental practice! Amazingly in the last ten days, I have treated five moms-to-be. But pregnancy isn’t the only thing these particular patients have in common.
Each one (with the exception of a veteran in her fourth pregnancy) called my office with this question: “Is it safe to have dental treatment during pregnancy?”
From my humble perspective as both a father who observed up close and personal two pregnancies that produced my own children, and from that of a dentist who has treated untold numbers of pregnant patients over the last three decades, pregnancy is truly one of life’s miracles. During this extraordinary time of gestation, moms-to-be experience a heightened sense of responsibility that goes beyond self and often leads to elevated consciousness of their health.
Some of the most important measures and behavioral changes most expectant mothers embrace to safeguard their baby’s health such as routine prenatal care; nutritional awareness (eating for two); abstention from smoking, alcohol consumption, drug use (both pharmaceutical and recreational); and getting regular exercise are some of the most important measures and behavioral changes that most expectant mothers embrace to safeguard their baby’s health.
What is often understated and sometimes even misunderstood, however, is the importance of having optimal dental health during pregnancy.
Preventive Dental Treatment Is Safe During Pregnancy
On their website, The American Dental Association states: “Preventive, diagnostic, and restorative dental treatments are safe throughout pregnancy”. Elective procedures such as tooth whitening, cosmetic dentistry, and more complicated procedures should be delayed until after the baby is born.
Novocaine During Pregnancy
“Novocaine” per se, has not been used in dentistry for many decades. We have more effective and better-formulated anesthetics today, but the term still persists. It is generally used as a euphemism for any local anesthetic.
The use of most local anesthetics is considered safe during pregnancy. As per The American Dental Association, local anesthetics such as lidocaine may be used during pregnancy.
The most common anesthetic used in modern dentistry is lidocaine. While it does pass through the placenta it is not toxic to the developing baby. In my practice, I use the minimum effective dose, but I do not compromise on ensuring complete comfort for my patient. Pain, in and of itself, can induce a physiologic response that is best avoided anytime, especially during pregnancy.
Many dentists use lidocaine combined with epinephrine (another word for adrenaline) but I tend to avoid it for my patients who are pregnant. Epinephrine is not dangerous to use during pregnancy, but it sometimes causes a transitory state of excitement with an accelerated heart rate that can be distressful.
What Is The Best Trimester For Dental Treatment During Pregnancy?
Avoid dental treatment during pregnancy in the first trimester, except for cleanings or emergency care. During this time most of the fetus’ organs and organ systems are developing. After the first trimester, the majority of formation is complete and the remainder of fetal development is devoted primarily to growth and maturation.
But the safest time to receive dental treatment during pregnancy is the second trimester. For pregnant women, my focus during this time is to control any active conditions such as decay (cavities) or gum disease. In this way, I eliminate problems that could show up later on in the pregnancy.
While it’s not dangerous to have dental treatment during the third trimester, the increasing size of the baby can make laying in the dental chair for an extended period of time very uncomfortable.
Which Medications Are Safe During Pregnancy?
During pregnancy, pain medication should be restricted to acetaminophen (Tylenol). Other pain medications such as aspirin and NSAIDs (such as ibuprofen and naproxen) should be avoided. If a stronger medication is necessary, I prescribe it only after consulting with my patient’s obstetrician.
Antibiotics such as penicillin, amoxicillin, cephalosporins, and clindamycin are considered safe for dental treatment during pregnancy. Tetracycline-related antibiotics, however, are not recommended because they have been found to cause the developing baby’s teeth to become stained.
What About X-Rays During Pregnancy?
While dental x-rays, especially digital ones, are considered safe for dental treatment during pregnancy, they must be used with the proper techniques and lead aprons. But most expectant mothers and their dentists (including me) try to avoid them unless absolutely necessary.
Not only is it safe to have dental treatment during pregnancy, but it is also recommended. If you’re expecting and nervous about going to the dentist, tell your dentist and hygienist your good news (even if it isn’t public knowledge yet). They will give you advice on how to properly care for your teeth and gums during this particularly vulnerable time and if you need dental treatment during your pregnancy, make sure your dentist speaks to your obstetrician before proceeding.
Congratulations and enjoy your pregnancy!
You may also be interested in this article: Tongue-Tie Can Cause Breastfeeding Problems
Michael Sinkin is a dentist in New York City. He loves being his professional and is known throughout the city for the wonderful care his patients get and his sense of humor. To contact Dr. Sinkin, click here.